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The treatment of osteochondritis dissecans (OCD) lesions remains contro-versial. We present a case series of 12 teenage patients with average 6 year follow-up after compression screw fi xation of unstable Cahill Type-2C OCD lesions. Postoperatively, patients were evaluated with several functional tests and scoring systems, including Lysholm, IKDC, and KOOS. All lesions healed, and no clinical or radiographic evidence of degenerative disease was noted. No signifi cant differences in thigh girth, range of motion, stability, or single-leg-hop distance was observed when compared to the unaffected, contralateral extremity. We conclude that this technique is appropriate and effi cacious for the treatment of unstable OCD lesions. The specifi c pathophysiology of osteochondritis dissecans (OCD) remains controversial. Originally thought to be an infl ammatory phenom-enon, various investigations point to vas-cular insuffi ciency,11 repetitive microtrau